樊 宇,杨历新

目的：在代谢性心血管疾病（CVD）负担上升背景下，阐明低氧作为“代谢—血管”轴共同上游病因的证据链。方法：系统梳理脂肪组织低氧、阻塞性睡眠呼吸暂停所致间歇性低氧（IH）以及内皮代谢重编程/铁死亡的基础、转化与临床研究，并综合干预证据。结果：三类低氧表型可并存并相互放大：脂肪组织低氧驱动炎症与胰岛素抵抗，IH通过交感与氧化炎症应激加重代谢紊乱和内皮功能障碍，铁死亡参与微血管病变的终端环节。减重+运动（含低氧训练）+优化CPAP，联用降脂及SGLT2抑制剂等可实现多点拦截。结论：以TyG、ODI及脂过氧化/铁代谢面板进行分层评估，联动依从性指标，有望明确“低氧减负”与代谢—血管获益的因果通路，支撑个体化干预。

低氧；间歇性低氧；代谢性心血管疾病；脂肪组织；内皮功能；铁死亡；HIF

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